The quality of life and functional outcome of charcot foot patient treated with reconstructive foot surgery

Abstract

There is minimal data regarding the quality of life and functional outcome of Charcot foot neuroarthropathy (CN) patient being treated surgically. This was a prospective study that evaluated the outcome of CN patients treated surgically. This study had compared the quality of life and functional outcome of patient with CN pre and post-operative foot and ankle reconstructive surgery done in Hospital Tengku Ampuan Afzan (HTAA), Kuantan and International Islamic University Malaysia Medical Centre (IIUM), Kuantan between 2016 and 2018. Patients were evaluated using SF-36 scores and AOFAS scores pre and post-operatively at minimum of 6 months. Thirty patients had undergone reconstructive foot and ankle surgery using hindfoot arthrodesis nail (HAN) and screws for arthrodesis. After an average follow-up of 6 months, the outcome was assessed using paired t-test comparing pre and post-operative in which their overall scores for SF-36 components were significant with p<0.0001. 86.7% of patients had undergone HAN procedure in which showed significant outcome for both scoring. Pain component of AOFAS showed lower score of improvement. Other components of AOFAS had significant improvement with p<0.0001. Two patients had suffered ulceration post operation that required multiple debridement and exostectomy with one patient required removal of HAN eventually. CN patients that undergone foot and ankle reconstructive surgery had a better quality of life and functional outcome. Surgical management depends on their stage of disease and anatomical location involvement that either HAN procedure or arthrodesis using screws could be done.